Peabody Alf Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL12841 Issued in FL

Legal business name

PEABODY ALF INC

Practice address

1309 Peabody Dr E
Jacksonville, FL 32221-1291

Phone

(904) 695-2967

NPI assigned

Jun 13, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Antonio Maulion Doctor Sr.

Title

Owner/Administrator

Phone

(904) 695-2967

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1465776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690934400000",
    "number": "1194174912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1309 PEABODY DR E",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322211291",
            "telephone_number": "904-695-2967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 PEABODY DR E",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322211291",
            "telephone_number": "904-695-2967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEABODY ALF INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-13",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A",
        "authorized_official_last_name": "DOCTOR",
        "authorized_official_first_name": "ANTONIO",
        "authorized_official_middle_name": "MAULION",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "904-695-2967",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL12841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.